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BackgroundA collaboration between the University of Michigan (UM) Cystic Fibrosis Center (CFC) and Marmara University (MU) CFC was initiated in MU through conducting Quality Improvement projects (QIP). The global aim was to improve nutritional status of children with CF (cwCF), with a specific aim to increase the mean BMI percentile (BMIp) for cwCF by 10 percentile points in 12 months. MethodsBody mass index (BMI) percentiles of cwCF were categorized as: nutritionally adequate (BMIp >= 50%); at risk (BMIp 25%-49%); urgently at risk (BMIp 10%-25%); critically at risk (BMIp < 10%). Appropriate interventions were made according to BMIp category every three months. Forced expiratory volume in one-second percent predicted (FEV1pp), and health-related quality of life (HRQoL) were evaluated. ResultsOne hundred and eight-two cwCF with a mean age of 9.1 +/- 4.3 years were included in the project. Baseline BMIp increased from 25.6 to 37.2 at the 12th month (p < 0.001). In the critically at-risk group BMIp increased from 3.6 to 20.5 (p < 0.001), in the urgently at risk group from 15.9 to 30.8 (p < 0.001), in the at risk group from 37.0 to 44.2 (p < 0.079) and in the nutritionally adequate group the increase was from 66.8 to 69.5 (p < 0.301). FEV1pp also improved significantly, from 81.3 +/- 20.6 to 85.9 +/- 20.8 (p < 0.001). Physical functioning, eating problems, and respiratory symptoms domains of the HRQoL evaluation improved (p < 0.05). ConclusionThis project has led to significant improvements in BMIp, FEV1pp and HRQoL of cwCF; similar projects could easily be implemented by centers in other developing countries.

Warburg micro syndrome (WARBM) is a rare, autosomal recessive, neurodevelopmental disorder characterized by microcephaly, cortical dysplasia, corpus callosum hypoplasia, congenital hypotonia leading to subsequent spastic quadriplegia, severe developmental delay and hypogenitalism. Ophthalmologic findings that may affect any ocular segment including characteristic, small, atonic pupils. WARBM is known to be caused by biallelic, pathogenic variants in at least five genes although additional genetic loci may exist. The RAB3GAP1 c.748 + 1G>A, p.Asp250CysfsTer24 founder variant has been described in families of Turkish ancestry. We report the clinical and molecular findings in three, unrelated, Turkish families with WARBM. A novel c.974-2A>G variant causing WARBM in three siblings of Turkish descent was found. Functional studies of the novel, c.2606 + 1G>A variant in patients\" mRNA revealed skipping of exon 22 which results in a premature stop codon in exon 23. However, the clinical consequences of this variant are blended given that the individual also had a maternally inherited chromosome 3q29 microduplication.

Backgrounds: Brucellosis is a systemic zoonotic disease. Osteoarticular (OA) system involvement is a common complication and the predominant manifestation of brucellosis in children. We aimed to evaluate the epidemiologic, demographic, clinical characteristics, and laboratory and radiologic findings of children with brucellosis and how these related to OA involvement. Methods: This retrospective cohort study consisted of all consecutive children and adolescents diagnosed as having brucellosis who were admitted to the pediatric infectious disease department of University of Health Sciences Van Research and Training Hospital between August 1, 2017, and December 31, 2018, in Turkey. Results: A total of 185 patients diagnosed as having brucellosis were evaluated, 50.8% had OA involvement (n = 94). Seventy-two patients (76.6%) exhibited peripheral arthritis involvement, among of them, hip arthritis (63.9%; n = 46) was the most common manifestation, followed by arthritis of knee (30.6%; n = 22), shoulder (4.2%; n = 3) and elbow (4.2%; n = 3). A total of 31 patients (33.0%) had sacroiliac joint involvement. Seven patients (7.4%) had spinal brucellosis. Erythrocyte sedimentation rate level above 20 mm/h at admission and age were independent predictor of OA involvement (respectively odds ratio [OR] = 2.82; 95% confidential interval [CI] = 1.41-5.64, ORperyear= 1.10; 95% CI: 1.01-1.19). Increasing age was associated types of OA involvement. Conclusion: A half of brucellosis cases had OA involvement. These results can help physicians to make early identification and diagnosis of childhood OA brucellosis who present with arthritis and arthralgia to enable the disease to be treated in time.

Paragangliomas and pheochromocytomas are rare tumors originating in chromaffin cells which are predominantly located in adrenal glands. This tumor is generally bilateral and much more rarely seen in pediatric patients. Sustained or paroxysmal hypertension is the most frequent sign of paragangliomas /pheochromocytoma. Here, we present a 15-year-old patient diagnosed with the complaint of blurred vision.

Respiratory distress syndrome (RDS) care pathways evolve slowly as new evidence emerges. We report the sixth version of “European Guidelines for the Management of RDS” by a panel of experienced European neonatologists and an expert perinatal obstetrician based on available literature up to end of 2022. Optimising outcome for babies with RDS includes prediction of risk of preterm delivery, appropriate maternal transfer to a perinatal centre, and appropriate and timely use of antenatal steroids. Evidence-based lung-protective management includes initiation of non-invasive respiratory support from birth, judicious use of oxygen, early surfactant administration, caffeine therapy, and avoidance of intubation and mechanical ventilation where possible. Methods of ongoing non-invasive respiratory support have been further refined and may help reduce chronic lung disease. As technology for delivering mechanical ventilation improves, the risk of causing lung injury should decrease, although minimising time spent on mechanical ventilation by targeted use of postnatal corticosteroids remains essential. The general care of infants with RDS is also reviewed, including emphasis on appropriate cardiovascular support and judicious use of antibiotics as being important determinants of best outcome. We would like to dedicate this guideline to the memory of Professor Henry Halliday who died on November 12, 2022.These updated guidelines contain evidence from recent Cochrane reviews and medical literature since 2019. Strength of evidence supporting recommendations has been evaluated using the GRADE system. There are changes to some of the previous recommendations as well as some changes to the strength of evidence supporting recommendations that have not changed. This guideline has been endorsed by the European Society for Paediatric Research (ESPR) and the Union of European Neonatal and Perinatal Societies (UENPS).

© 2022 Elsevier B.V.Objective: Objective methods to monitor the sleep of preterm infants at the neonatal intensive care unit (NICU) are required to prevent potentially adverse neurodevelopmental outcomes. This study aimed to determine the concordance of actigraphy and amplitude-integrated electroencephalogram (aEEG) against gold standard direct observation (DO) in assessing sleep/wake states of typically developing preterm infants. Methods: This prospective observational study was conducted in a single center level III NICU. Sleep variables were measured using Philips Respironics Mini-Mitter® Actiwatch-2 for 24 h and compared with 8-h matched data of aEEG and DO. Sensitivity-specificity analysis, Cohen's kappa, prevalence-adjusted and bias-adjusted kappa (PABAK), and Bland Altman plots were generated. Results: Seventeen preterm infants were recruited. A total of 11252 epochs were studied. Sensitivity (86.4%), agreement rate (67.9%), and predictive value for wake (47.9%) for the actigraphy were highest at the automatic activity threshold whereas specificity (54.5%) and predictive value for sleep (75.5%) were highest at low threshold. The sensitivity of aEEG was 79.3% and the specificity was 54.3%. At all thresholds, the agreement was largely equivalent with low kappas (0.14–0.17) and PABAK coefficients (0.22–0.35) for actigraphy and DO. Moderate agreement was observed between aEEG and DO according to the PABAK coefficient (0.44). Mean differences in sleep parameters were not different between DO and aEEG as well as DO/aEEG and actigraphy at medium threshold (p > 0.05). Conclusions: Actigraphy at medium threshold can be used in depicting sleep in typically developing preterm infants at NICU. aEEG may be an alternative adjunctive method to actigraphy for the evaluation of sleep/wake states in the NICU setting. Clinical trial registration number: NCT04145362

Amaç: Annenin gebelik döneminde kilo artışının yenidoğanın ölçülen ilk TSH düzeyleri üzerine etkisini araştırmaktır.Gereçler: Güngören 30 Ağustos Aile Sağlığı Merkezinde; takip edilen 112 gebe ve bu gebelerin 112 bebeği retrospektif olarak incelendi. Gebelerin boy, kilo ölçümleri ve vücut kitle indekslerinin (VKİ) hesaplandığı gebelik haftaları, bebeklerin doğum tartıları ve TSH değerleri alındı. Gebeler, normal (VKİ, Aim: To investigate whether the mother's weight gain during pregnancy affects the newborn first measured TSH levels.Material and Methods: In Gungoren 30 Ağustos Family Health Center; 112 pregnant and 112 babies were included. The height, weight, and body mass index (BMI) with gestational weeks (gw) of pregnant and birth weight(BW) and TSH levels of newborns were taken. Pregnants were categorized into three groups as normal (BMI

ÖzetAmaç: Çalışmanın amacı adenotonsiller hipertrofi (ATH) nedeni ile adenoidektomi ve/veya tonsillektomi operasyonlarının Enürezis Noktürna (EN) üzerindeki etkisini araştırmaktır.Gereç ve Yöntemler: Adenoidektomi ve/veya tonsillektomi operasyonu uygulanmış olan 94 hastanın dosyaları retrospektif olarak incelendi. Hastalarda EN sıklığı ve operasyon sonrası düzelip düzelmediği araştırıldı.Bulgular: Ortalama yaş 9.59±2.04 yıl idi. adenoid vegetasyon (AV) sorunu olan grupta EN hasta sayısı fazla idi. Cerrahi öncesi hastaların 73’ünde EN tespit edildi. Operasyon sonrası 63 hastada tam iyileşme,10 hastada kısmi iyileşme söz konusu idi. Gruplar arası EN iyileşmesi ile ilgili istatistiksel açıdan anlamlı farklılık yoktu.Sonuç: Multidisipliner yaklaşım gerektiren EN tedavisinde ATH cerrahi prosedürleri etkin olabilmektedir. Bu nedenle, EN semptomları olan hastalarda üst solunum yolu obstrüksiyonuna ait şikayetlerin sorgulanması ve semptomu olan çocuklara yapılacak doğru cerrahi prosedür tedavini önemli bir basamağı oluşturabilir., Objective: The aim of this study was to investigate the effect of tonsillectomy and adenoidectomy on (Enuresis Nocturna) EN in patients with tonsil hypertrophy and adenoid hypertrophy.Material and Methods: Data of 94 patients was retrospectively valuated. The frequency of EN of the patients and whether they improved after the operation were investigated.Results: The mean age was 9.59±2.04 year. EN patients was higher in the group with adenoid vegetation. EN was detected in 73 of the patients before surgery. There was a complete improvement in 63 patients and partial improvement in 10 patients after the operation. There was no statistically significant difference in EN improvement between the groups.Conclusion: In a multidisciplinary approach, the surgical procedures can be effective in the treatment of EN. Therefore the patients admitting with EN symptoms should be questioned for complaints about upper airway obstruction and the correct surgical procedure for children with symptoms may constitute an important step in their treatment.

Introduction The Plethysmographic Variability Index can be measured by both finger and forehead probes. Vasoconstriction may jeopardize the reliability of finger PVI measurements in pediatric patients undergoing surgery. However, forehead vasculature exhibits more marked resistance to alterations in the vasomotor tonus. Objective Our aim was to compare the Plethysmographic Variability Index measured via finger or forehead probes in mechanically ventilated pediatric surgery patients in terms of their ability to predict fluid responsiveness as well as to determine the best cut-off values for these two measurements. Materials and Methods A total of 50 pediatric patients undergoing minor elective surgery were included after provision of parental consent and ethics committee approval. Perfusion index measured at the finger or forehead and Plethysmographic Variability Index monitoring comprised the primary assessments. Hemodynamic parameters monitored included perfusion index, Plethysmographic Variability Index, and cardiac output. A >= 15% increase in cardiac output following passive leg raise maneuver was considered to show fluid responsiveness. Two groups were defined based on fluid responsiveness: Group R (responsive) and Group NR (non-responsive). Student\"s t-test, Mann-Whitney U test, DeLong test, and ROC were used for statistical analysis. Results The area under curve for finger and forehead Plethysmographic Variability Index prior to passive leg raise maneuver were 0.699 (p = .011) and 0.847 (p < .001), respectively. The sensitivity for finger and forehead measurements at a cut-off value of

© 2022-IOS Press. All rights reserved.Sjögren-Larsson syndrome (SLS) is a rare neurocutaneous disorder characterized by the presence of congenital ichthyosis, spasticity, and mental retardation. As with other rare genetic diseases, treatment is mainly symptomatic. Due to the absence of definitive treatment, lifelong follow-up and support of patients are important to improve the quality of life. A 7-year-old female child who was diagnosed as having SLS was referred to the rehabilitation clinic. After 20 sessions of a rehabilitation program, she started walking independently with the additional contribution of ankle-foot orthoses (AFOs). The contribution of the short-term rehabilitation approach and especially the administration of AFOs to the independence level of the patient is emphasized herein.

Background and Aim Pulmonary embolism (PE) is a potentially life-threatening disease in children. The objective of the study is to evaluate the utility of adult-based pulmonary embolism rule-out criteria (PERC), Pediatric PE Model, and D-dimer in the diagnosis of PE in children. Material and Methods The study consisted of patients under 18 years of age who were consulted to the Pediatric Pulmonology Clinic for the evaluation of PE. Patients were divided into two groups based on the confirmation of PE. The group with the presence of PE (n = 20) consisted of children who were diagnosed with PE. The group with the absence of PE (n = 28) consisted of children with clinically suspected PE but negative diagnostic imaging. Adult validated clinical decision PERC rule and Pediatric PE Model were retrospectively applied to the patients. Results In the study, PERC demonstrated a sensitivity of 60% and a specificity of 46% for the diagnosis of PE in children. When PE Model was evaluated for the children, it was found a 50% sensitivity and 75% specificity. Combining PE Model and PERC rule with D-dimer did not increase the specificity and sensitivity. Smoking was found to be relevant for PE in the childhood. Twenty-five percent of the patients had a genetic tendency for PE. All of the patients had an underlying disease as well. Conclusion None of the current risk assessment tools (PE Model, PERC, D-dimer) were found to be accurate in predicting PE. Further larger population studies are still required to develop a better diagnostic approach.

Oral mucositis, which refers to erythematous and painful ulcerative lesions of the oral mucosa, is one of the most common adverse events associated with cancer therapies in the pediatric population. Although the pharmacologic and supportive therapy management of cancer treatment has advanced, the mucositis frequency is still increasing. Different methods and therapeutic agents are used in the prevention and treatment of oral mucositis, including basic oral care protocol, antimicrobial agents, cryotherapy, antiseptic agents, antibiotics, vitamins, cytokines, immune regulators, and herbal methods. Non-medical mouthwashes are recommended in basic oral care protocols. There is no conclusive evidence that mouthwashes contain chlorhexidine, normal saline, sodium bicarbonate, and benzydamine to prevent oral mucositis. Vitamin E can be an effective treatment method in reducing the severity of oral mucositis. Cryotherapy is a preferable treatment method according to the degree of mucositis in cooperative children receiving chemotherapy. There are different results in the literature regarding using chlorhexidine, laser therapy, and glutamine in children. It is recommended to avoid its use until its efficacy is demonstrated in systematic reviews and meta-analysis studies for its use in pediatric oncology patients. This review aims to evaluate the recommended and not recommended agents and practices in the prevention and treatment of oral mucositis in pediatric oncological patients receiving chemotherapy., Oral mukozit, pediatrik popülasyonda kanser tedavileriyle ilişkili en yaygın görülen yan etkilerden biridir. Oral mukozanın eritamöz ve ağrılı ülseratif lezyonlarıyla seyretmektedir. Kanser tedavilerinde farmakolojik ve integratif tedavi yönetimlerine karşın mukozit görülme sıklığı fazladır. Oral mukozitin önlenmesinde/tedavisinde kullanılan farklı metodlar ve terapötik ajanlar bulunmaktadır. Bunlar; temel ağız bakım protokolü, antimikrobial ajanlar, kriyoterapi, antiseptik ajanlar, antibiyotikler, vitaminler, sitokinezler, immun regülatörler ve bitkisel yöntemlerdir. Temel ağız bakım protokollerinde medikal olmayan gargaralar önerilmektedir. Klorheksidin, normal salin, sodyum bikarbonat ve benzidamin içeren gargaraların oral mukozitin önlenmesine ilişkin kesin kanıtları yoktur. E vitamini, oral mukozit şiddetini azaltmada etkili bir tedavi yöntemi olabilmektedir. Kriyoterapi, kemoterapi alan ve koopere çocuklarda mukozit derecesine göre tercih edilebilir bir tedavi yöntemidir. Klorheksidinin, lazer terapinin ve glutaminin çocuklarda kullanımıyla ilgili literatürde farklı sonuçlar bulunmaktadır ve pediatrik onkoloji hastalarında kullanımına yönelik sistematik derleme ve meta-analiz çalışmalarında etkinliği gösterilene kadar kullanımından kaçınılması önerilmektedir. Bu derlemenin amacı, kemoterapi alan pediatrik onkoloji hastalarında oral mukozitin önlenmesi ve tedavisinde önerilen ve önerilmeyen metodların ve ajanların incelenmesidir.

Introduction: The aim of this study is to evaluate the demographic, clinical and laboratory characteristics and treatment results of pediatric patients followed up with the diagnosis of brucellosis in our clinic.Methods: Patients who were followed up with the diagnosis of brucellosis in Kayseri Training and Research Hospital, Pediatric Infectious Diseases Clinic between October 2016 and December 2018 were retrospectively analyzed.Results: A total of 37 patients, 26 (70.3%) male, were included in the study. The mean age of the patients whose ages ranged from 1 to 17 years was 9.3±4.3 years. Unpasteurized milk and/or dairy products were consumed in 86.5% of the patients and 48.6% had a family history of brucellosis. Joint pain (75.7%) was the most common presenting complaint. In the laboratory evaluation, 8.1% of the patients had leukopenia, 2.7% had thrombocytopenia and 21.4% had ALT elevation. Doxycycline plus rifampicin (43.2%) was the most commonly preferred treatment regimen. Addition of aminoglycoside to initial therapy in hospitalized patients was statistically higher than in outpatients (81.2% vs. 23.8%) (p=0.001). During the follow-up, relapse developed in a total of 4 (10.8%) patients, 3 of whom were outpatients. There was no statistical relationship between the initial treatment regimen and relapse (p=0.418).Conclusion: In conclusion, brucellosis should be kept in mind in terms of differential diagnosis in patients who present with joint pain in our country and who have cytopenia and/or isolated aminotransferase elevation in their investigations.Keywords: Child, Brucellosis, Relapse, Giriş: Bu çalışmada, kliniğimizde bruselloz tanısıyla takip edilen hastaların demografik, klinik, laboratuvar özellikleri ve tedavi sonuçlarını değerlendirmeyi amaçladık.Yöntem: Kayseri Eğitim ve Araştırma Hastanesi, Çocuk Enfeksiyon Hastalıkları Kliniği’nde Ekim 2016-Aralık 2018 tarihleri arasında bruselloz tanısıyla takip edilen hastalar retrospektif olarak incelendi.Bulgular: Çalışmaya 26’sı (%70.3) erkek toplam 37 hasta alındı. Yaşları 1 ile 17 arasında değişen hastaların yaş ortalaması 9.3±4.3 yıldı. Hastaların %86.5’inde pastörize edilmemiş süt ve/veya süt ürünü tüketimi, %67.6’sında ailede hayvancılık ve %48.6’sında da ailede bruselloz öyküsü vardı. Eklem ağrısı (%75.7) en sık başvuru yakınması olarak saptandı. Laboratuvar değerlendirilmesinde hastaların %8.1’inde lökopeni, %2.7’inde trombositopeni ve %21.4’ünde ALT yüksekliği vardı. Tedavide doksisiklin artı rifampisin (%43.2) en sık tercih edilen rejimdi. Hastanede yatan hastalarda başlangıç tedavisine aminoglikozid eklenmesi, ayaktan hastalara göre istatistiksel olarak daha yüksekti (%81.2'ye karşı %23.8) (p=0.001). Takipte 3’ü ayaktan takip edilen olgular olmak üzere toplam 4 (%10.8) hastada relaps gelişti. Başlangıç tedavi rejimi ile relaps arasında istatistiksel bir ilişki yoktu (p=0,418).Sonuç: Sonuç olarak, ülkemizde eklem ağrısı yakınmasıyla başvuran tetkiklerinde sitopeni ve/veya izole aminotransferaz yüksekliği saptanan hastalarda bruselloz ayırıcı tanılar açısından akılda tutulmalıdır.Anahtar kelimeler: Çocuk, Bruselloz, Relaps

Objective: We aimed to present the characteristics, genetic analysis results, long-term prognosis of our patients with distal kidney tubular acidosis, and the relationship between hyperammonemia and distal kidney tubular acidosis. Materials and Methods: Biochemical, clinical, and imaging findings were collected at presentation and the last clinic visit, and results of the genetic analysis were recorded. Results: Our study included 9 patients (3 female, 33%). The median age at diagnosis was 3 months, and the median follow-up period was 111 months. Height standard deviation scores were less than −2 in 4 (44%) patients at presentation and in 3 (33%) at the last clinic visit. The median estimated glomerular filtration rate was 98 mL/min/1.73 m2 at presentation and 126 mL/min/1.73 m2 at the last clinic visit. We have found 8 different types of mutations of 2 genes, including 6 in the ATP6V0A4 gene, 2 in the SLCA4A1 gene, and 2 of them were novel. At the time of presentation, nephrocalcinosis and hypercalciuria were present in all our patients, but at the last visit, only 1 patient had hypercalciuria. Sensorineural hearing loss was found in 4 of our patients with a mutation in the ATP6V0A4 gene. Serum ammonia levels were found to be high in 3 patients with mutations in the ATP6V0A4 gene. Conclusion: Adequate metabolic control is essential for optimal growth and preserved kidney function in distal kidney tubular acidosis patients. Distal kidney tubular acidosis may be associated with hyperammonemia. We recommend keeping potassium levels at high-normal levels to reduce ammonia levels, especially in the absence of acidosis.

Biallelic RNPC3 variants have been reported in a few patients with growth hormone deficiency, either in isolation or in association with central hypothyroidism, congenital cataract, neuropathy, developmental delay/intellectual disability, hypogonadism, and pituitary hypoplasia. To describe a new patient with syndromic congenital hypopituitarism and diffuse brain atrophy due to RNPC3 mutations and to compare her clinical and molecular characteristics and pituitary functions with previously published patients. A 20-year-old female presented with severe growth, neuromotor, and developmental delay. Her weight, height, and head circumference were 5135 gr (-25.81 SDS), 68 cm (-16.17 SDS), and 34 cm (-17.03 SDS), respectively. She was prepubertal, and had dysmorphic facies, contractures, and spasticity in the extremities, and severe truncal hypotonia. There were no radiological signs of a skeletal dysplasia. The bone age was extremely delayed at 2 years. Investigation of pituitary function revealed growth hormone, prolactin, and thyroid-stimulating hormone deficiencies. Whole-exome sequencing revealed a novel homozygous missense (c.1328A > G; Y443C) variant in RNPC3. Cranial MRI revealed a hypoplastic anterior pituitary with diffuse cerebral and cerebellar atrophy. The Y443C variant in RNPC3 associated with syndromic congenital hypopituitarism and abnormal brain development. This report extends the RNPC3-related hypopituitarism phenotype with a severe neurodegenerative presentation.

The diagnosis of brain death is primarily clinical. Sometimes ancillary tests are needed.This study compared sensitivity and interobserver agreement of the 10-, 7- and 4-point CT angiography scoring systems for the diagnosis of brain death in children.CT angiography examinations of 50 pediatric patients with a clinical diagnosis of brain death were evaluated according to 10-, 7- and 4-point scoring systems. Images were evaluated by two radiologists who considered the vessel opacification first in the arterial phase (AUsing the clinical exam as the reference standard, we found sensitivities for 10-, 7- and 4-point scoring systems to be 70%, 88% and 92% in the AJust as in adult age groups, in children the 4-point scale appears to be more sensitive than the 10- and 7-point scales for CT angiography-based assessment of brain death. Because the scoring systems have similar sensitivities, they could be used as ancillary tests in pediatric cases.

Introduction: Endogenous Cushing’s syndrome (CS) is a rare, severe disease that can cause multiple systemic involvement and behavioral problems due to excessive cortisol production. Structural changes can be noted in the brain magnetic resonance imaging (MRI) scans of these cases. Cases: A 9-year-old girl and a 13-year-old boy were admitted with hypercortisolism. In the female patient, altered consciousness was prominent along with cerebral and cerebellar brain atrophy, and findings indicating posterior reversible encephalopathy syndrome were detected in the brain MRI. Although the male patient's neurological examination was normal, significant cerebral atrophy was seen in the brain MRI. Case 1 was diagnosed as having ectopic ACTH syndrome (EAS) due to a thymic carcinoid tumor. Case 2 underwent a pulmonary lobectomy upon detection of a bronchial lesion in the Ga-68 DOTATATE PET/CT scan while being examined for EAS due to a lack of suppression in the high-dose dexamethasone suppression test. However, hypercortisolism persisted despite the removal of the bronchial lesion, and subsequently, a diagnosis of Cushing’s disease was established following bilateral inferior petrosal sinus sampling. Discussion: Endogenous hypercortisolism may cause brain atrophy of varying severity. Central nervous system findings can be overlooked in children with CS. More comprehensive studies are needed to better understand the behavioral changes caused by the effects on the brain and to evaluate whether these changes are reversible. In addition, identifying the source of hypercortisolism can be difficult due to a lack of experience related to the rarity of the disease in children.

Pediatrik grupta, normal gelişim gösteren çocuklarda işitme, dil ve konuşma gelişiminin aşamalarını bilmek, bu becerilerdeki bozukluk ya da gecikmelerin ayırt edilmesinde yol gösterici olmaktadır. İşitme kaybı varlığında, kaybın erken dönemde saptanması ve uygun müdahalelerin gerçekleştirilmesiyle çocuğunun normale yakın bir gelişim süreci geçirmesi sağlanır. Uygun müdahalelerin içeriğinde çocuğun yaşına, gelişim sürecine uygun işitme ve dil eğitimleri bulunmaktadır. Erken tanılanan, erken cihazlandırılan çocuklar için işitme ve dil gelişim seviyelerine uygun eğitim programları olmazsa olmazdır. İşitme ve dil eğitimi ile çocuğun ifade edici ve alıcı dilini geliştirmesi desteklenir. Dil ve konuşmayı değerlendiren testler ile, yapılan bu müdahalelerin ve rehabilitatif yaklaşımların faydasını ve çocuğun mevcut gelişim düzeyini belirlemede, tanıya gitmede kullanışlı ve pratik değerlendirme ölçütleri sağlanmış olur. Dil ve konuşmayı değerlendirme testlerinin multidisipliner çalışmalarda kullanımı, çocuğun gelişiminin farklı yönleriyle ve detaylıca değerlendirilmesini, bu değerlendirmelerin bilimsel çalışmalara ışık tutmasını sağlayacaktır. Dil ve konuşmayı değerlendirme testleri ile çocuğun alıcı ve ifade edici dili değerlendirilebildiği gibi, belirli dil gelişimsel bozukluklara yönelik olarak yapılan afazi, kekemelik gibi durumları değerlendirmek üzere geliştirilmiş testler de mevcuttur. Bu derlemede pediatrik grupta kullanılan dil ve konuşmayı değerlendirme testlerine odaklanılmıştır. Bu bağlamda Türkçe Erken Dil Gelişimi Testi, Türkçe İfade Edici ve Alıcı Dil Testi, Türkçe Okul Çağı Dil Gelişim Testi, Okul Öncesi Dil Ölçeği, Resim Kelime Tanıma Testi, Ankara Artikülasyon Testi, Erken Okuryazarlık Testi, Türkçe Sesletim ve Sesbilgisi Testi, Kekemelik Şiddeti Değerlendirme Aracı ve Afazi Dil Değerlendirme Testi’ne değinilmiştir. Bu araştırma aracılığıyla, bu testlerin amaçları, uygulanacağı yaş grupları, geçerlik ve güvenirlik bilgileri, içerikleri, materyalleri, alt testleri, puanlandırma sistemleri ve test maddelerinin dağılımı bildirilmiştir., Knowing the stages of speech, language, and hearing development in young patients developing normally helps to detect issues (or delays) with their abilities. By identifying the loss early on and carrying out the necessary interventions, it is possible to promise that a child with hearing loss will experience a developmental phase close to normal. Training in hearing and language appropriate for the child’s age and developmental stage constitutes appropriate therapies. Early identification and receiving hearing aids or auditory implants in children necessitate educational programs— suitable for their language and hearing development stages. Hearing and language instruction aid in children’s expressive and receptive language development. In addition to the child’s current developmental stage, the tests that measure language and speech provide significant and valuable evaluation criteria for figuring out how effective these interventions and rehabilitative approaches will be in making the diagnosis. The use of language and speech assessment tests in multidisciplinary research enables detailed and comprehensive evaluations of the child’s development, which will shed light on scientific investigations. The child’s receptive and expressive language—as well as aphasia and stuttering for certain language developmental disorders—can be assessed using language and speech assessment tools. This review focuses on language and speech assessment tests used in the pediatric group. Test of Early Language Development, Turkish Expressive and Receptive Language Test, Test of Language Development-Primary, Preschool Language Scale, Picture-Vocabulary Test, Ankara Articulation Test, Early Literacy Test, Turkish Pronunciation and Phonology Test, Stuttering Severity Instrument 4, and Aphasia Language Assessment Test are all mentioned in this context. This study documented the objectives of these tests, the target age groups, the reliability and validity data, the content, materials, subtests, scoring procedures, and the distribution of test items.

Evaluation of emergency department (ED) presentation by Syrian refugee children might provide important information about their health care needs. For this purpose, we compared ED presentation of refugee and resident children in a tertiary university hospital in Istanbul, Turkey.Electronic medical records of Syrian refugee children ≤ 18 years old presenting to the ED between January 2013 and July 2019 were retrospectively reviewed and compared with resident children.The study population consisted of 7299 refugees and 690,127 resident children admitted to the ED. High-acuity cases were more frequent in Syrian refugees (2.2% vs 1% p 0.001). One-third of Syrian children were under 12 months of age (31% vs 17%, p 0.001). Syrian children were more commonly hospitalized (7.9% vs 3.1% p 0.001). The median age (and interquartile range - IQR) was lower in hospitalized refugee than in resident children [12 (0-83) months vs 41 (8-111) months, p 0.001]. Rate of intensive care unit hospitalization (13% vs 9.4%, p = 0.001) and neonatal hospitalization was higher in Syrians compared to resident children (29% vs 12%, p 0.001). The median NICU stay was longer in refugees [6 (IQR 4-17) days vs 3 (IQR 1-9) days, p 0.001].Refugee children, as compared to resident children, are more likely to present to the ED with high acuity conditions and at a younger age resulting in higher rates of inpatient admissions. Strategies to increase access to preventive health care services for young refugee children should be explored to decrease ED and hospital services and improve health outcomes.• Children are the most affected victims of armed conflicts in terms of health outcomes. • Refugees prefer to access healthcare through the emergency department.• Refugee children were more likely to present as urgent when compared to resident children. • Admission to neonatal and intensive care units was more frequent among refugee than resident children.

Amaç: Çocuk romatoloji polikliniğine tekrarlayan ateş sendromu şüphesi ile yönlendirilen hastaların değerlendirilmesi amaçlandı. Yöntem: Mart 2018-Mart 2019 tarihleri arasında çocuk romatoloji polikliniğinde tekrarlayan ateş sendromu tanısı alan hastalar değerlendirildi. Bulgular: Bir yıl süresince toplam 1561 hastaya romatolojik hastalık tanısı konuldu. Bu hastaların 738 (%47,3)’ini tekrarlayan ateş sendromları oluşturmaktaydı. Hastaların 591’i ailevi Akdeniz ateşi (AAA), 91’i aftöz stomatit, farenjit ve adenit ile giden periyodik ateş sendromu (PFAPA), 2’si mevalonat kinaz (MVK) eksikliği-hiperimmünoglobulin D sendromu (HİDS), 2’si kriyopirin ilişkili periyodik ateş sendromu (CAPS), 1’i tümör nekroz faktör (TNF) reseptörü ilişkili periyodik ateş sendromu (TRAPS) tanısı aldı. Sınıflandırma ölçütlerine uymayan ve genetik inceleme sonuçlarında mutasyon saptanmayan 51 hastaya ise sınıflandırılamayan otoinflamatuar hastalık-tekrarlayan ateş sendromu tanısı konuldu. Sonuç: Tekrarlayan ateş sendromlarının teşhisi dikkatli bir değerlendirme gerektirir. Hastanın belirti ve bulgularının detaylı bir şekilde sorgulanması çocuk romatoloji birimlerine gereksiz yönlendirmelerini önleyecek ve sağlık harcamalarını azaltacaktır., Objective: We aimed to evaluate the patients referred to the pediatric rheumatology outpatient clinic with suspected periodic fever syndromes. Method: Patients diagnosed with periodic fever syndrome in the pediatric rheumatology outpatient clinic between March 2018 and March 2019 were evaluated. Results: A total of 1561 patients were diagnosed with rheumatologic disease in a year-long period. Of these patients, 738 (47.3%) had recurrent fever syndromes. Of these, 591 patients had familial Mediterranean fever (FMF), 91 had periodic fever syndrome with aphthous stomatitis, pharyngitis and adenitis (PFAPA), 2 had mevalonate kinase (MVK) deficiency-hyperimmunoglobulin D syndrome (HIDS), 2 had cryopyrinassociated periodic fever syndrome (CAPS) and 1 patient was diagnosed with tumor necrosis factor (TNF) receptor-associated periodic fever syndrome (TRAPS). Fifty-one patients who did not comply with the classification criteria and did not carry any mutations in the genetic tests were diagnosed with undefined autoinflammatory disease. Conclusion: The diagnosis of periodic fever syndromes requires attentive evaluation. A detailed questioning of the symptoms and signs of the patient will prevent unnecessary referrals to pediatric rheumatology units and will decrease the expenses of healthcare.

There are various oral symptoms related to the disease and its management in individuals with chronic kidney disease (CKD). The aim of the study was to investigate the oral health status of children with different stages of CKD, kidney transplant recipients (KTR), and healthy children.A total of seventy-one children diagnosed with CKD and fifty-two healthy children were included in the study. Each patient was examined for dental caries by the decayed-missing-filled-teeth (DMFT/dmft) index and the International Caries Detection and Assessment System (ICDAS-II), developmental defects of enamel (DDE) by the DDE index, and oral hygiene by the debris (DI), calculus (CI), and simplified oral hygiene (OHI-S) indices.The median number of DMFT/dmft was 1.00 (interquartile range (IQR):1.00-4.00) in children with stage 1-3 CKD, 0.00 (IQR: 0.00-2.50) in stage 4-5 children, 0.00 (IQR: 1.00-3.00) in KTR, and 8.00 (IQR: 1.00-13.00) in healthy children. According to ICDAS-II categories, the percentage of children with severe caries was 53.8% in healthy children, while it was 44.4% in KTR, 25.9% in stage 1-3, and 11.4% in stage 4-5 children. While the percentage of children with DDE was 88.8% in KTR, 80% in stage 4-5, and 66.7% in stage 1-3 children, this rate was 44.2% in healthy children. The highest mean OHI-S score was observed in stage 4-5 children (2.10 ± 1.08), followed by KTR (1.46 ± 1.19), stage 1-3 (1.27 ± 0.61), and healthy children (0.45 ± 0.44), respectively.Compared to healthy children, children with CKD had more debris accumulation, calculus formation, and more DDE but a lower severity of dental caries. A higher resolution version of the Graphical abstract is available as Supplementary information.

Giriş ve Amaç: Hipoglisemi, yenidoğanın en sık metabolik sorunudur ve uzun sürmesi ya da sık tekrarlaması durumunda serebral zedelenmeye neden olabilir. Bu çalışmanın amacı doğum sonrası anne yanında izlenen ve risk faktörü olan yenidoğan bebeklerde hipoglisemi sıklığını belirlemek, hipoglisemi taramasının önemini ve hipoglisemiden korunmada da anne sütünün önemini vurgulamaktır. Gereç ve Yöntemler: Çalışmaya Mayıs 2020 ile Mayıs 2021 tarihleri arasında hastanemizde doğan ve anne yanında izlenen, risk faktörü olan yenidoğan bebekler alındı. Bebeklerde ilk kan glukozu, beslendikten 30 dakika sonra ölçüldü. Beslenme ile normoglisemik değerler elde edilmesi durumunda, ölçüm 2-3 saat aralıklarla ve beslenme öncesi olacak şekilde tekrarlandı, yaşamın 48. saatinde tarama sonlandırıldı. Hipoglisemi gelişen bebeklerle gelişmeyen bebekler demografik özellikleri, beslenme şekilleri ve kan glukoz değerleri açısındn karşılaştırıldılar.Bulgular: Çalışmaya risk faktörü olan ve hipoglisemi taraması yapılan 260 bebek alındı. Bu bebeklerin 109’u (%41,9) preterm bebek, 62’si (%23,8) diabetik anne bebeği (DAB), 32’si (%12,3) gebelik haftasına göre büyük bebek (LGA), 10’u (%3,8) gebelik haftasına göre küçük bebek (SGA) ve 47’si (%18,1) intrauterin büyüme kısıtlılığı (İUBK) olan bebeklerdi. Yapılan taramada 260 bebeğin 24’ünde (%9,2) hipoglisemi saptandı. Bebeklerin %78,5’inde ilk beslenme anne sütüyken, sonraki beslenmelerde sadece anne sütü ile beslenen bebeklerin oranının %50,8’e düştüğü görüldü. İzlem boyunca sadece anne sütü alan bebeklerde anlamlı olarak hipogliseminin daha az olduğu görüldü (p=0,003).Sonuç: Risk faktörü olan bebeklerin, özellikle de diabetik anne bebeklerinin doğum sonrası hipoglisemi taramalarının yapılması önemlidir. Hipoglisemi riski taşıyan bu bebeklerin, hipoglisemiden korumak için hem erken hem de geç dönemde sadece anne sütü ile beslenmeleri sağlanmalıdır., Objective: Hypoglycemia is the most common metabolic problem of the newborn and may cause cerebral injury if it persists for a long time or if it recurs frequently. The aim of this study is to determine the frequency of hypoglycemia in newborn babies with risk factors and to emphasize the importance of screening for hypoglycemia and the importance of breast milk in the prevention of hypoglycemia.Materials and Methods: Newborn babies with risk factors born in our hospital between May 2020 and May 2021 and followed up with their mothers were included in the study. The first blood glucose in infants was measured 30 minutes after feeding. If normoglycemic values were obtained with feeding, the measurement was repeated at 2-3 hour intervals and before feeding, and scanning was terminated at the 48th hour of life. Babies who developed hypoglycemia and babies who did not develop were compared in terms of demographic characteristics, feeding patterns and blood glucose values.Results: 260 infants with risk factors and screening for hypoglycemia were included in the study. Of these infants, 109 (41.9%) were preterm infants, 62 (23.8%) were infants of diabetic mothers (DAB), 32 (12.3%) were large for gestational age (LGA), 10' u (3.8%) were small for gestational age (SGA) and 47 (18.1%) were infants withintrauterine growth restriction (IUGR). In the scan, hypoglycemia was found in 24 (9.2%) of 260 babies. While the first feeding was breast milk in 78.5% of the infants, it was observed that the rate of infants fed only with breast milk decreased to 50.8% in subsequent feedings. During the follow-up period, it was observed that hypoglycemia was significantly less in babies who received only breast milk (p=0.003).Conclusion: It is important to screen for postnatal hypoglycemia in babies with risk factors, especially babies of diabetic mothers. These babies, who are at risk of hypoglycemia, should be fed only with breast milk both in the early and late periods in order to protect them from hypoglycemia.

Background/Aim: Although leukemia is thought to be triggered or initiated by viral infections, it is not clear which viruses are the causative agents for which stage of the disease. Previous studies have shown that the MxA protein is expressed from blood mononuclear cells in reply to inducement of type I interferons in viral infections. Viral infections may trigger childhood B-cell acute lymphoblastic leukemia (B-ALL), and the hypothesis of this study was the detection of the presence of viral infection by measuring MxA expression in blood mononuclear cells of recently diagnosed pediatric B-ALL patients as a surrogate viral marker. Methods: This study consisted two groups; the study group consisted of 30 newly diagnosed B-ALL and the control group consisted of 29 healthy asymptomatic children of similar age. Proven bacterial infection and COVID-19 PCR positivity were exclusion criteria. Bacterial culture of peripheral blood, complete blood count, plasma CRP levels and whole blood MxA levels detected by ELISA (Enzyme-Linked ImmunoSorbent Assay) method were taken. Results: The patients’ mean age was 7.42 years in the leukemia group (previously mentioned as study group) and 7.25 years in the control group. Routine serologic studies for newly diagnosed leukemia patients (CMV, EBV VCA and Hepatitis B IgM, anti-HCV and anti-HIV) were negative in all patients without any bacterial infection detected. The MxA levels were found significantly higher in children with B-ALL than in control group (5.84 (2.18-199.38) and 2.45 (1.17-88.65) ngr/ml, respectively, with P

Background/Aim: Obstetric brachial plexus injury (OBPI) is caused by traction to the brachial plexus during labor. Traction injury may vary from neurapraxia or axonotmesis to neurotmesis and can cause edema, avulsion, or rupture of the nerve. Improvement in the first two weeks after birth is a good indicator of outcome. The disability varies according to the location and severity of the effect in the plexus. However, most injuries are transient, with a total return of function in many cases. This study aimed to obtain clues for the prevention and follow-up of obstetric brachial plexus injuries by revealing the outcome and clinical features.Methods: In this retrospective cohort study, hospital records of patients with brachial plexus injury due to delivery were reviewed between January 2017 and September 2021. Injury levels, birth weights, other injuries at birth, maternal age, gravidity, gestation time, and treatment response were recorded. Brachial plexus injuries of the patients were classified per the NARAKAS classification. The Spearman correlation and Pearson correlation tests were used for correlation analyses. The variables were evaluated with the Chi-Square and Student's t-tests. The normality of the distribution was assessed with the Kolmogorov-Smirnov test. A value of P

AmaçCiddi ve orta derece preterm bebeklerde kordon kanı nötrofil değerlerinin erken yenidoğan sepsisi (EYS) ve EYS risk etmenleri ile ilişkisinin belirlenmesi amaçlandı. Çalışma planı Geriye dönük çalışmamızda ünitemizde en az yedi gün yatırılan, 28-34 gebelik haftaları arasında doğan olgular değerlendirildi. Göbek kordonundan ya da yaşamın ilk iki saatinde venöz alınan kan sayımları ile kan kültürü sonuçları, CRP değerleri, EYS için risk etmenleri ve klinik özellikler kaydedildi. BulgularHastaların (n=100) ortalama doğum ağırlıkları ve gebelik haftaları sırasıyla 1617±408 gram ve 32,19±1,6 hafta idi. Olguların 33’ünün kordon, 67’sinin doğum sonrası ilk iki saat içinde alınan venöz nötrofil sayıları değerlendirildi. Kordon kanı ve venöz nötrofil değerleri arasında fark saptanmadı (p=0,936). Erken yenidoğan sepsisi ve EYS risk etmeni olanlarla olmayanlar arasında nötrofil değerleri açısından fark saptanmadı (sırasıyla p=0,076, 0,95). Nötrofil düzeyleri gebelik haftası ve doğum ağırlığı ile aynı, CRP değerleri ile zıt yönlü ilişikili saptandı (sırasıyla r, p= 0,282, 0,004; 0,437, 0,0001; -0,209, 0,037). SonuçKordon kanı ve venöz kan nötrofil düzeyleri ile EYS ve EYS risk etmenleri arasında ilişki saptanmadı. Bulgularımız preterm bebeklerde nötrofil değerlerinin gebelik haftası ve doğum ağırlığı göz önüne alınarak değerlendirilmesi gerektiğini düşündürmektedir., IntroductionIt was aimed to determine the relationship between cord blood neutrophil values and early onset neonatal sepsis (ENS) and ENS risk factors in very and moderate preterm infants.MethodsIn our retrospective study, the cases who were born between 28-34 weeks of gestation and hospitalized for at least seven days were evaluated. Blood counts obtained from umbilical cord or in the first two hours of life, blood culture results, CRP values, risk factors for ENS, and clinical features were recorded.ResultsThe mean birth weight and gestational age of patients (n=100) were 1617±408 grams, and 32.19±1.6 weeks, respectively. In the 33 of the cases the cord blood, and in the 67 of the cases venous neutrophil counts taken within the first two hours after delivery were evaluated. There was no difference between cord and venous blood neutrophil values (p= 0.936). There was no difference in terms of neutrophil values between those with/without ENS and with/without ENS risk factors (p = 0.076, 0.95, respectively). Neutrophil levels were positively correlated with gestational week and birth weight, and negatively correlated with CRP values (r, p = 0.282, 0.004; 0.437, 0.0001; -0.209, 0.037, respectively).ConclusionNo relationship was found between cord blood/ venous blood neutrophil levels and ENS/ ENS risk factors. Our findings suggest that neutrophil values should be evaluated by considering gestational age and birth weight in preterm infants.

Impaired muscle strength, proprioceptive and vestibular deficits, and orthopedic dysfunction are common disorders associated with Down syndrome (DS). Hippotherapy uses the horses’ multidimensional movement to improve posture, balance, and overall function, both motor and sensory. Research evidence supports hippotherapy as an effective, medically recognized intervention for the rehabilitation of gross motor skills. The aim of this study was to determine the effect of hippotherapy on balance, functional mobility, and functional independence in children with DS. Thirty-four children with DS were randomly assigned to the experimental (hippotherapy) and control groups after the initial assessment. Both groups received physiotherapy including balance exercises, and the experimental group also received hippotherapy as an integrative therapy. Pediatric Balance Scale (PBS), Timed Up and Go Test (TUG), and Functional Independence Measure for Children (WeeFIM) were used before and after the intervention. Baseline outcome measures (PBS, TUG, WeeFIM) were statistically similar between groups (p > 0.05). After the intervention, PBS and TUG scores improved in both groups (p < 0.05). On the other hand, WeeFIM scores improved just in the hippotherapy group (p < 0.05). Conclusion: Therefore, providing hippotherapy as an integrative therapy to physiotherapy will be more effective in improving the functional independence of children with DS. Trial registration: NCT05297149 (March 2022, retrospectively registered).What is Known:• Hippotherapy has an improvement effect on balance and functional independence in different diseases and age groups, but the evidence is limited in DS.• There is limited evidence about the effect of hippotherapy on functional mobility in different diseases and age groups, but there is no evidence in DS.What is New:• Hippotherapy is a safe and effective approach to support improvement in functional independence in children with DS.

Objective: Childhood injury is a significant public health problem. This study aimed to evaluate the awareness of families about accident/injury risks both indoors and outdoors and provide counselling within the scope of parent education by using tools related to environmental safety. Material and Methods: This study was a two-centered, prospective study conducted with the participation of parents with children under the age of five. Initially, a preliminary assessment was made using a questionnaire. Then, face-to-face training was provided using an infographic brochure from the “Basic Information for Families for Child Health and Safety in the First 5 Years” booklet created by the Child Health Association (https:// cocuksagligidernegi.org/). Parents were given a “Safety Checklist” so they could assess child safety at home. In the third and sixth months, families were called and asked questions again about their attitudes and behaviors towards preventing accidents/injuries. Results: A total of 157 parents were included in the study. It was determined that the rates of safe behavior in-car safety, sleep safety, toy safety, kitchen and bathroom safety, and indoor arrangements increased statistically. Conclusion: Family counseling and education can lead to behavioral change to create a safe environment for children and prevent accidents/ injuries. Multifaceted initiatives are more likely to successfully reduce injuries at home and increase the effectiveness of education with the use of infographic materials, continuity of education, preparing checklists to be applied at home and sharing them with families., Amaç: Çocukluk çağında yaralanmalar önemli bir halk sağlığı sorunudur. Çalışmamızda, ailelerin hem iç, hem de dış mekanlarda kaza/yaralanma riskleri konusundaki farkındalıklarını değerlendirmeyi ve çevre güvenliği ile ilgili araçlar kullanarak anne baba eğitimi kapsamında danışmanlık vermeyi amaçladık. Gereç ve Yöntemler: Çalışmamız, beş yaşından küçük çocuğu olan anne babaların katılımı ile yürütülen iki merkezli, ileriye dönük bir çalışmadır. Başlangıçta, anket kullanılarak ön değerlendirme yapıldı. Çocuk Sağlığı Derneği (https://cocuksagligidernegi.org/) tarafından hazırlanan “İlk 5 Yaşta Çocuk Sağlığı ve Güvenliği İçin Ailelere Temel Bilgiler” kitapçığından hazırlanan bir infografik broşür kullanılarak yüz yüze eğitim verildi. Anne babalara evlerinde çocuk güvenliğini değerlendirebilmeleri için bir “Güvenlik Kontrol Listesi” verildi. Üçüncü ve altıncı aylarda aileler aranarak kazaları/yaralanmaları önlemeye yönelik tutum ve davranışlarını değerlendiren sorular tekrar soruldu. Bulgular: Çalışmaya toplam 157 anne baba alındı. Eğitimden sonra; araç içi güvenlik, uykuda güvenlik, oyun ve oyuncak güvenliği, mutfak ve banyo güvenliği ve iç mekan düzenlemelerine ilişkin güvenli davranış oranlarının istatistiksel olarak arttığı saptandı. Sonuç: Aile danışmanlığı ve eğitimi, çocuklar için güvenli bir ortam yaratmak ve kazaları/yaralanmaları önlemek için davranış değişikliğine yol açabilmektedir. İnfografik materyallerin kullanılması, eğitimin sürekliliğinin sağlanması, evde uygulanacak kontrol listelerinin hazırlanması ve ailelerle paylaşılması eğitimin etkinliğini artıracağından çok yönlü girişimlerin evdeki yaralanmaları başarılı bir şekilde azaltması daha olasıdır.

Sleep health is one of the major contributors to mental and physical health and as such should be an essential component of informed community and policy conversations around health. Non-physiological sleep problems are commonly referred to as Behavioral Sleep Problems (BSP) and include difficulties initiating sleep alone, bedtime resistance, difficulties re-initiating sleep after normally occurring overnight waking (requiring parental assistance to re-settle) and/or early morning wakening. BSP affects up to 40% of children under two years of age. Despite the high prevalence and impact of sleep disturbance, training and education curricula for pediatric medical and allied health professions include little information or awareness building about sleep, particularly in strategies to ameliorate sleep for children and their families. An evident need to train health professionals working with children in evidence-based pediatric behavioral sleep care is emerging. A recent partnership between Turkey and Australia has tackled this problem. By developing a scientific collaborative network between the two countries and using existing evidence-based methods, clinical information was shared between health professional workforces in these two countries as effective ways of translating knowledge in pediatric sleep interventions. Systematic training of primary and tertiary medical and allied health professionals must be considered as standard practice in tertiary education settings.

Amaç: Bu çalışmanın amacı doğum sonu dönemde annelerin yaşadığı stresin emzirme öz-yeterliliğe etkisini belirlemektir.Gereç ve Yöntem: Araştırma analitik ve kesitsel tiptedir. Araştırmanın verileri bir devlet hastanesinin çocuk polikliniklerinde anket formu kullanılarak toplanmıştır. Çalışma 148 anne ile tamamlanmıştır. Verilerin analizinde tanımlayıcı istatistiksel metodları, Student t Test, Pearson Ki-Kare testi ve Korelasyon t testi kullanılmıştır.Bulgular: Katılımcıların Doğum Sonu Stres Ölçeği puan ortalamaları 21-34 yaş aralığında, üniversite mezunu olan, çalışıp şuan ücretsiz izinde olan, gelir düzeyi iyi olan, çekirdek ailede yaşayan, eşi üniversite mezunu olan ve eşi çalışmayan kadınlarda daha yüksektir. Emzirme Öz-yeterlilik Ölçeği puan ortalamalarına bakıldığında ise, primigravidalarda, abortusu olanlarda ve 3 ve üzeri yaşayan çocuğu olan, gebeliği planlı olmayan, normal doğum yapan ve bebeği 36 hafta ve altında doğan kadınların puanları daha yüksek saptandı (p, Aim: The aim of this study is to determine the effect of stress experienced by mothers in the postpartum period on breastfeeding self-efficacy.Materials and Method: The research is of analytical and cross-sectional types. The data of the study were collected by using a questionnaire in the pediatric outpatient clinics of a state hospital. The study was completed with 148 mothers. Descriptive statistical methods, Student t Test, Pearson Chi-Square test and Correlation t test were used in the analysis of the data.Results: Participants’ Postpartum Stress mean score is higher for women who are between the ages of 21-34, who are university graduates, who are working but are currently on unpaid leave, have a good income, live in a nuclear family, whose spouse is university graduate and whose spouse is not working. When the mean scores of the Breastfeeding Self-Efficacy Scale were examined, it was found that the scores of primigravidas, those with abortion and those with 3 or more living children, who had no planned pregnancy, had a vaginal delivery, and whose babies were born at 36 weeks or less were higher (p

Hospital social workers often engage in health literacy activities to support patients’ and families’ functioning and adjustment to illness, but social work literature has seldom used health literacy terminology. This paper reports on a qualitative study of paediatric hospital social workers’ understanding of the needs of parents with acutely ill children and how their contributions may accommodate these needs to strengthen parental health literacy. Utilising systematic text condensation, the study reveals four themes: (1) understanding of medical information, (2) counselling and service coordination, (3) emotional needs, and (4) timing of information. The findings suggest that hospital social workers make valuable additions to health literacy. Sykehussosionomer jobber med å fremme sykdomsmestring hos pasienter og deres familier. Sette arbeidet har i liten grad blitt omtalt som et bidrag til å styrke helsekompetansen til pasienter og pårørende. Artikkelen bygger på en kvalitativ studie med pediatriske sykehussosionomer, om deres forståelse av foreldres behov når et barn er akutt og kritisk sykt, og hvordan de møter disse behovene på måter som kan bidra til å styrke foreldrenes helsekompetanse. Det har blitt benyttet Systematisk tekstkondensering som analysemetode for å komme frem til fire temaer; (1) å forstå medisinsk informasjon, (2) veiledning og koordinering av tjenester, (3) følelsesmessige behov, og (4) timing av informasjon. Funnene støtter opp om at sykehussosionomenes arbeid kan bidra til å styrke pasienter og pårørendes helsekompetanse. Deres helhetlige tilnærming kan utgjøre verdifulle bidra til helsekompetansefeltet.

Aims The study aimed to determine the effect of using a crochet octopus to reduce acute pain and maintain optimal physiological measurements that develops during procedural pain in neonates. Materials and methods This was a parallel design randomized controlled study. During the procedure of heel lance, experimental groups were delivered a crochet octopus 10 min before the process and let them touch the octopus during and for up to 10 min after the procedure. Control group experienced the process without any intervention. SpO2, duration of crying of neonates and pain they experienced were evaluated. Results The study was completed with 100 (50 for the experimental group and 50 for the control group) term neonates. SpO2 of neonates, touching the crochet octopus during and after in second minute of the process was found higher and also the duration of crying was shorter during whole the process, and the pain they experienced due to the process was lower than the control group. Conclusions Crochet octopus affected physiological measurements of the neonates positively and reduced the procedural pain as well.

Yenidoğanın alloimmün hemolitik hastalığının (YHH) etiyolojisinde Rhesus D dışındaki antikorların önemi giderek artmaktadır. Anti E, c ve Kell antikorlarının birlikte olduğu YHH daha önce bildirilmemiştir. Bu olgu sunumunda ciddi hemolitik hastalık ve sarılık nedeni ile tekrarlayan intravenöz immunoglobulin (İVİG) ve eritrosit transfüzyonu ile tedavi edilen bir vakayı sunmak istedik. Erkek yenidoğana doğumdan sonra 2 ve 3. günde 1 gr/kg IVIG verildi. Eritrosit transfüzyonu 6. günde yapıldı. Postnatal 12. günde hemoliz bulgularının devam etmesi üzerine 3. doz İVİG 1 gr/kg dozunda verildi. Taburculuk sonrası 3. haftada hemoliz bulguları saptanmadı. Sonuç olarak hemoliz, anemi ve sarılık saptanan yenidoğanlarda nadir olsa da birden fazla subgrup uyuşmazlığının olması akla gelmelidir. Fototerapi, İVİG ve eritrosit transfüzyonu tedavi seçenekleri arasındadır., Maternal Ig-G type blood group antibodies other than Rhesus D (RhD) are an increasingly significant cause of alloimmune hemolytic disease of the newborn (HDN). Anti-E, c and Kell associated HDN has not been reported in the literature. We report first case report of this combination with severe hemolytic anemia and hyperbilirubinemia requiring repeated doses of intravenous immunoglobulin (IVIG) and erythrocyte transfusion. He received 1 g/kg IVIG therapy on postnatal day 2 and 3 because of hemolysis. Erythrocyte transfusion was performed on postnatal day 6. Third dose IVIG as 1 gr/kg was given because of ongoing hemolysis on postnatal day 12. Three weeks after discharge he had no hemolysis. In conclusion, isoimmunization due to combination of subgroup incompatibility such as anti-E, c and Kell should be considered in patients with hemolysis, anemia and jaundice although combination of these isoimmunization is rare. Phototherapy, IVIG and erythrocyte transfusion are treatment options.

Objectives: To assess neonatal sepsis and associated factors among neonates admitted neonatal intensive care unit in selected public hospitals in Somali region, Ethiopia. Methods: Institution based cross sectional study design was conducted in selected public hospitals. Data was collected using structured questionnaire adopted from other literature, entered into Epi-data version 3.1 and then was exported to SPSS version 23 for analysis. Frequency was used for descriptive analysis. Bivariate analysis was used to determine the association between different risk factors and the outcome variable. Those variables which have significant association at 5% significance level and fulfilling the minimum requirement of 0.2 level of significance with neonatal sepsis was entered for further analysis to multivariate analysis, significance was taken at α = < 0.05. Results: The overall prevalence of this study was 42.9% CI = (38.4-47.8) and associated factors was age of the neonate AOR = 0.085 (CI = 0.01, 0.73), Residence shown AOR = 2.567 (CI = 1.01, 6.5) Gestational age AOR = 1.869 (CI = 1.05, 3.31), Meconium stained Amniotic fluid AOR = 2.718 (CI = 1.89, 6.74), Antenatal care AOR = 8.933 (CI = 4.9, 15.9), and Mechanical ventilation after birth OR = 3.376 (CI = 1.65, 6.88). Conclusions: The present study found that the overall prevalence of neonatal sepsis in selected hospitals was 42.9%. The study identified, Age of the neonate, Residence, Gestational age, Meconium stained amniotic fluid. Antenatal care, Mechanical ventilation after birth. The findings underscore the importance of routine assessment and close monitoring of neonates. It is therefore recommended to have more skilled health personnel and advanced equipment while providing maternal and new-born health care services.

Introduction: Mastocytosis is characterized by the excessive proliferation and accumulation of mast cells in organs such as the spleen, liver, lymph nodes, skin, gastrointestinal tract, and bone marrow. Cutaneous mastocytosis, which is only presented with skin involvement, is frequently seen in childhood. Objective: It was aimed to determine the demographic and clinical characteristics of patients with cutaneous mastocytosis and the knowledge level of families about the disease, and to raise awareness about this disease. Material and Methods: The records of 25 cases with cutaneous mastocytosis were evaluated retrospectively and the knowledge levels of the families were measured with a questionnaire. Results: The mean follow-up period of 25 patients was 39 months. The most common type of the disease was urticaria pigmentosa (60%). Itching (n=14) was the most common symptom in patients. Only 2 patients were carrying adrenaline auto-injectors. While 60% of the families (n=15) had fears about the disease; of these 15 families, 53.3% (n=8) were afraid of the re-spread of the disease, 13.3% (n=2) turning of the disease into skin cancer, 13.3% (n=2) occupation of the internal organs, 13.3% (n=2) having a new attack, and 0.4% (n=1) re-forming of the spots. Conclusion: The cutaneous forms of mastocytosis are mostly observed in childhood, and systemic involvement is rare. Mastocytosis progresses with rashes in childhood and its findings are limited to the skin. Families should be better informed about mastocytosis and the need for patients to carry an adrenaline auto-injector due to the risk of attacks should be explained to them., Giriş: Mastositoz, mast hücrelerinin dalak, karaciğer, lenf nodu, deri, gastrointestinal yol, kemik iliği gibi organlarda aşırı çoğalması ve birikmesi ile karakterize bir hastalıktır. Sıklıkla çocukluk çağında sadece deri tutulumu ile seyreden kutanöz mastositoz tipi görülür. Amaç: Kutanöz mastositozlu hastaların demografik ve klinik özelliklerini belirlemek, ailelerin hastalık hakkında bilgi düzeylerini ölçmek ve bu hastalık hakkında farkındalık oluşturmak amaçlanmıştır. Gereç ve Yöntemler: Kutanöz mastositoz tanısı alan 25 olgunun dosyası geriye dönük olarak değerlendirildi ve ailelere kutanöz mastositoz ile ilgili bilgi düzeylerini ölçmek için anket uygulandı. Bulgular: İzlem süresi ortalama 39 ay olan 25 kutanöz mastositozlu hasta çalışmaya dahil edildi. Hastaların %60’ı ürtikerya pigmenzota tipinde idi. Kaşıntı en sık olarak görülen semptom (n=14) idi. Sadece 2 hastamız adrenalin oto enjektörü taşımaktaydı. Ailelerin %60’ında (n=15) hastalık ile ilgili korkular mevcuttu; bu 15 ailenin %53,3’ü (n=8) hastalığın tekrar yayılmasından, %13,3’ü (n=2) cilt kanserine dönüşmesinden, %13,3’ü (n=2) iç organların tutulmasından, %13,3’ü (n=2) atak geçirmesinden, %0,4’ü (n=1) lekelerin tekrar oluşmasından korkmakta idi Sonuç: Mastositoz çocukluk çağında döküntülerle beraber seyreden ve kendini cilt bulguları ile sınırlayan bir hastalıktır. Çocukluk çağında daha çok kutanöz formu görülen hastalığın sistemik tutulumu nadir görülür. Ailelerin mastositoz hastalığı hakkında bilgilendirilmesi ve atak geçirme riskine yönelik adrenalin oto enjektörü taşıması gerekliliği anlatılmalıdır.

COVID-19 was declared a pandemic by the World Health Organization on March 11, 2020. Due to the high contagiousness of the disease, changes have been made in the provision of health services all over the world, and health authorities have made calls to reduce hospital admissions except for urgent reasons. Access to non-COVID-19 healthcare services has declined sharply due to the restrictions imposed to prevent viral spread, fears about the uncertainty of the disease, the redirection of healthcare professionals to the follow-up, treatment and care of infected patients, the lack of personal protective equipment, and the financial difficulties brought on by the pandemic. The population most affected by this situation caused by COVID-19 has undoubtedly been children. Due to changes in health service delivery, maternal and child health services have been interrupted, and immunization rates have decreased greatly. The closure of outpatient clinics, inpatient services and the conversion of operating rooms to intensive care units in order to intervene with infected patients have caused delays in the diagnosis and treatment of acute or chronic diseases in children. Children with chronic diseases experienced shortages of drugs or medical equipment, and children who needed rehabilitation services could not receive supportive care. In addition, preventive mental health services could not be maintained with the closure of schools. Decreases in access to health services may have negative consequences on childhood mortality and morbidity all over the world, especially in low and middle-income countries. It is important to examine the data in the world in terms of maintaining the achievements for child health and planning health services in Turkey. Therefore, this review aimed to examine the effects of the decrease in access to health services on child health during the global epidemic process., COVID-19, Dünya Sağlık Örgütü tarafından 11 Mart 2020 tarihinde pandemi olarak ilan edilmiştir. Hastalığın yüksek bulaşıcılığı nedeniyle tüm dünyada sağlık hizmetleri sunumunda değişikliklere gidilmiş, sağlık otoriteleri acil nedenler dışında hastane başvurularının azaltılması çağrıları yapmıştır. Viral yayılımı önlemek için uygulanan kısıtlamalar, hastalığın belirsizliğine ilişkin korkular, sağlık profesyonellerinin enfekte hastaların takibi, tedavisi ve bakımına yönlendirilmesi, kişisel koruyucu ekipman eksikliği ve pandeminin getirdiği finansal zorluklar nedeniyle COVID-19 dışı sağlık hizmetlerine erişim oranlarında keskin bir düşüş yaşanmıştır. COVID-19’un neden olduğu bu durumdan en çok etkilenen popülasyon şüphesiz ki çocuklar olmuştur. Sağlık hizmeti sunumundaki değişiklikler nedeniyle ana-çocuk sağlığı hizmetleri sekteye uğramış, bağışıklama oranları büyük ölçüde azalmıştır. Enfekte hastalara müdahale edebilmek için polikliniklerin kapatılması, yataklı servisler ve ameliyathanelerin yoğun bakımlara dönüştürülmesi çocukların akut veya kronik hastalıklarının tanı ve tedavilerinde gecikmelere neden olmuştur. Kronik hastalığı olan çocuklar ilaç veya tıbbi ekipman sıkıntısı yaşamış, rehabilitasyon hizmetlerine ihtiyaç duyan çocuklar destekleyici bakım alamamışlardır. Ayrıca okulların kapatılmasıyla koruyucu ruh sağlığı hizmetleri sürdürüle- memiştir. Sağlık hizmetlerine erişim oranlarındaki azalmalar, başta düşük ve orta gelirli ülkeler olmak üzere tüm dünyada çocukluk çağı mortalite ve morbiditesi üzerinde olumsuz sonuçlar doğurabilir. Türkiye’de çocuk sağlığına yönelik kazanımların sürdürülmesi ve sağlık hizmetlerinin planlanması açısından dünyadaki verilerin incelenmesi önemlidir. Dolayısıyla bu derlemede, küresel salgın sürecinde sağlık hizmetlerine erişimdeki azalmanın çocuk sağlığı üzerindeki etkilerinin incelenmesi amaçlanmıştır

Son yıllarda sağ kalım oranlarındaki artışa rağmen, çocukluk çağı kanserleri ölüm nedenleri arasında ilk sıralarda yer almaktadır. Oral ve sistemik enfeksiyonlar, yoğun tedavi protokolleri ile tedavi edilen kanserli hastaların yönetiminde önemli sorunlardan biridir. Kanserli hastalarda sepsisin en önemli ve en sık görülen kaynak yeri ağızdır. Mikroorganizmalar, normal mukoza bariyerinin bozulduğu mukozit gibi durumlarda dolaşıma katılarak sistemik enfeksiyonların gelişmesine neden olabilir. Tedavi sırasında oral enfeksiyonlar, hastaların %40-90’ında görülebilir. Enfeksiyonla ilişkili risk faktörleri; nötropeni/nötrofil fonksiyonlarında bozukluk, lenfopeni/lenfosit fonksiyonlarında bozukluk, mukozit, ağız kuruluğu, yetersiz beslenme, kötü oral hijyen, kanserin tipi, evresi ve tedavi protokolü, önceki oral/oral dışı enfeksiyonların öyküsü, geçirilmiş pulpal, periodontal hastalık, perikoronit ve endodontik tedavi öyküsü olarak sayılabilir. Kanser tanısı konulan hastalar, tedavi öncesi diş hekimi tarafından görülmeli, tedavi öncesi yeterli zamanı varsa, diş dolgusu, çekimi, periodontal bakım ve tedavisi planlanmalıdır. Ancak çocuklarda büyüme hızı yüksek tümörler görüldüğünden tanı ve tedavide daha hızlı yaklaşım gereklidir ve çoğu kez yeterli zaman yoktur. Sonuç olarak kanserli çocuklarda oral enfeksiyonlar, önemli bir morbidite ve mortalite nedenidir. Ağız ve diş muayenesi, kanser tanısı alan çocuklar- da tedavi öncesi değerlendirilmeli, tedavi sırasında da rutin muayenenin bir parçası olmalıdır. Hasta ve ailelerine bu konuda düzenli eğitim verilmelidir. Şüpheli lezyonlardan kültür ve/veya biyopsileri yapılmalı ve uygun tedavi gecikmeden başlanmalıdır., Despite the increase in survival rates, childhood cancers are among the leading causes of death. Oral and systemic infections are one of the most important problems in the management of cancer patients treated with intensive treatment protocols. The most important and common source of sepsis in patients with cancer is the mouth. Microorganisms can contribute to the development of systemic infections. The absence of a normal barrier facilitates sepsis in cases such as mucositis. Oral infections during treatment can be seen in 40-90% of patients. Risk factors associated with infection are neutropenia/ neutrophil dysfunction, impairment in lymphopenia/lymphocyte functions, mucositis, dry mouth, malnutrition, poor oral hygiene, type of cancer, stage, and treatment protocol, history of previous oral/non-oral infections, history of previous pulpal and periodontal disease, pericoronitis, and endodontic treatment. Patients diagnosed with cancer should be seen by the dentist before treatment, and if there is enough time before treatment, dental filling, extraction, and periodontal care and treatment should be planned. However, because tumors with a high growth rate are observed in children, a faster approach is required in diagnosis and treatment. Often, there is not enough time. As a result, oral infections are an important cause of morbidity and mortality in children with cancer. Oral and dental examination should be evaluated before treatment in children diagnosed with cancer. During treatment, they should also be part of the routine examination. Patients and their families should be given regular training in this regard. Culture and/or biopsies should be performed from suspicious lesions and appropriate treatment should be initiated without delay.

Amaç: Bu çalışma 18-49 yaş grubu evli kadınların anne sütü bankalarına ilişkin bilgi ve görüşlerini belirlemek amacıyla tanımlayıcı olarak yapılmıştır. Gereç ve Yöntem: Araştırma Sivas il merkezinde yer alan iki Aile Sağlığı Merkezi (ASM)’nde yürütülmüştür. Belirtilen ASM’lere 31.10.2018- 31.12.2018 tarihleri arasında çeşitli nedenlerle başvuran ve araştırmaya katılmayı kabul eden 18-49 yaş grubundaki evli kadınlar (n=190) araştırmanın örneklemini oluşturmuştur. Veriler araştırmacılar tarafından geliştirilen bir form kullanılarak toplanmıştır. Veriler SPSS 22 programında sayı, yüzde, ortalama ve standart sapma değerleri ile sunulmuş, istatistiksel analizde ki-kare testi kullanılmıştır. Bulgular: Kadınların %67,4’ü anne sütü bankasını duymamış, %90,5’i Türkiye’de anne sütü bankası olup olmadığını bilmemekte, %32,6’sı anne sütü bankası kurulmasını istememektedir. Buna karşın kadınların %35,3’ü ihtiyacı olduğunda bebeğini beslemek için süt bankasından süt alabileceğini, %46,8’i sütünü bankaya bağışlayabileceğini, %61,1’i anne sütü bankasından alınan sütlerin bebekler için mamadan daha iyi bir seçenek olacağını belirtmiştir. Sonuç: Kadınların anne sütü bankalarına yönelik tutumları nispeten olumludur. Türkiye’de anne sütü bankalarına ilişkin bilgilendirilme çalışmalarının yaygınlaştırılması ve mevcut kaygılara ilişkin sektörler arası bilgilendirme ve işbirliği yapılması önerilmektedir., Objective: This study was performed descriptively to determine th eknowledge and views of married women aged 18-49 regarding breast milk banks. Materials and Methods: The study was carried out at two Family Health Centers (FHC) in Sivas city center. The married women (n=190) aged between 18 and 49 who applied to the specified FHC between 31st October and 31st December, 2018, for various reasons and who agreed to be included in the study constituted the sample of the study. The data were collected by the researchers by means of a questionnaireand then presented in SPSS 22 program with number, percentage, mean and standard deviation values. The chi-square test was used for statistical analysis. Results: It was found that 67.4% of women had never heard about breast milk banks, 90.5% did not know of the existence of breast milk banks in Turkey, and 32.6% were unwilling for breast milk banks to be established. The study further concluded that 35.3% of the womencould benefit from breast milk banks when needed. Moreover, 46.8% of the women said that they would donate their breast milkand 61.1% stated that breast milk from a bank is a better option for infants than formula milk. Conclusions: Women’s attitudes towards breast milk banks are relatively positive. A recommendation arising from this study is that information about breast milk banks in Turkey should be more readily available and that there should be morecollaboration between sectors on current concerns.

Objective: Excessive crying is one of the most common complaints in the first months of life. Although various theories have been proposed to explain infantile colic, the etiology is still unclear. The aim of this study is to measure fecal calprotectin levels in infants with and without infantile colic and to investigate their possible relationship with inflammation. Methods: Infants attending a General Pediatrics Clinic in Medipol Mega University Hospital constituted the study population. Fecal calprotectin levels were measured using the Elisa Method in a total of 70 infants aged 1-3 months, 35 of which had infantile colic. A total of 42 infants, 22 of whom were in the colic group and 20 of them in the control group were followed for one year. Results: The socio-demographic features and feeding types of the infants with or without infantile colic were similar. Fecal calprotectin levels were significantly higher in the colicky babies, and all had calprotectin levels > 250 μgr/g. The median fecal calprotectin values of the colic and control groups were 651 μgr/g and 354 μgr/g, respectively. No significant difference was found between the cases where the calprotectin levels were higher or lower than 350 μg/g in terms of birth weight, gender, mode of delivery, diet and use of probiotics. During the follow-up, symptoms of food allergy occurred in 4 patients in the control group and in 3 patients in the study group. Conclusion: High fecal calprotectin levels in the colic infants suggest that infantile colic and intestinal inflammation may be associated., Amaç: Doğumu izleyen ilk üç ayda aşırı ağlama çok sık rastlanan bir yakın- madır. İnfantil kolik etyolojisi kesin olarak aydınlatılamamıştır. Son yıllarda intestinal mikrobiyatadaki değişikliklerin koliğe neden olabileceği ileri sürülmektedir. Çalışmamızın amacı dışkıda kalprotektin düzeylerinin ölçü- lerek kolik ile intestinal inflamasyon ilişkisinin araştırılmasıdır. Gereç ve Yöntem: Medipol Mega Üniversite hastanesi Genel Pediatri Polikliniğinde yapılan çalışmada 1-3 ay arası infantil kolikli 35 bebek (çalış- ma grubu) ile koliği olmayan 35 bebek olmak üzere toplam 70 bebeğin dışkıda kalprotektin düzeyleri İÜ Çocuk Gastroenteroloji Laboratuarında Elisa yöntemiyle ölçüldü. Kolik grubunda 22, kontrol grubunda 20 olmak üzere toplam 42 bebek bir yıl boyunca izlendi. Bulgular: Çalışma ve kontrol grubu bebekleri doğum tartısı, cins, doğum şekilleri, beslenme biçimleri açısından karşılaştırıldığında iki grup arasın- da fark saptanmadı. Çalışma grubunda kalprotektin düzeyleri anlamlı derecede yüksek olup, tüm olgularda fekal kalprotektin düzeyleri >250 μgr/g bulundu. Çalışma grubunun median kalprotektin değeri 651 μgr/g kontrol grubunun median değeri ise 354 μgr/g ölçüldü. Kalprotektin düzeyleri 350 μgr/g’den yüksek ve düşük olan olgular arasında doğum tartısı, cins, doğum şekli, beslenme biçimi ve probiyotik kullanımı açısın- dan anlamlı fark saptanmadı. Takipte kontrol grubunda 4, çalışma gru- bunda 3 olgu besin alerjisi tanısı aldı. Sonuç: Kolik bebeklerde yüksek dışkı kalprotektin seviyeleri, infantil kolik ve intestinal inflamasyonun ilişkili olabileceğini düşündürmektedir.

Objective: Adolescent obesity is a widely important situation around the world. According to current studies, Turkey is the most obese country in Europe. For the improvement and protection of public health, adolescents should be guided for healthy eating habits. This studyaims todetermine the nutritional status of students in adolescenceand investigate their obesity status. Material and Methods: The research is a descriptive study which has 204 students randomly selected from an Anatolian High School in Amasya. The data were collected through a questionnaire. The survey contains demographic information; eating habits and a food frequency form. Results: According to the results, 59.3% female and 40.7% are male with the average age being 15.88±0.86 years; the average weight 59.9±11.6kg; the average height 168.1±8.63cm; the average BMI 21.1±3.25kg/m2. In results, the percentiles of the Body Mass Index (BMI) by age and weight for age, females have more normal results (p, Amaç: Adölesanlarda obezite tüm dünyada oldukça önemli bir durumdur. Güncel araştırmalara göre Türkiye, Avrupa’nın en obez ülkesidir. Koruyucu sağlık politikaları önem kazanmıştır. Halk sağlığının iyileştirilmesi ve korunması için adölesanların sağlıklı beslenme alışkanlıkları konusunda yönlendirilmesi gerekmektedir. Bu çalışmada adölesan dönemindeki öğrencilerin beslenme durumlarının belirlenmesi ve obezite durumlarının incelenmesi amaçlanmıştır. Gereç ve Yöntem: Araştırma tanımlayıcı bir çalışmadır. Çalışma grubu Amasya’daki bir Anadolu Lisesi’nden rastgele seçilen 204 öğrenciden oluşmaktadır. Veriler, literatür taraması sonucunda araştırmacılar tarafından oluşturulan bir anket ile toplanmıştır. Anket demografik bilgileri, yeme alışkanlıkları ve bir besin tüketim sıklığı formunu içermektedir. Bulgular: Sonuçlara göre katılımcıların %59,3’ü kız, %40,7’si erkektir. Ortalama yaş 15,88±0,86’dır; ortalama ağırlık 59,9±11,6kg’dır; ortalama boy 168.1±8.63cm; ortalama Beden Kitle İndeksi (BKİ) 21.1±3.25kg/m2’dir. Sonuçlarda yaşa ve ağırlığa göre BKİ persentilleri, kızlarda erkeklere göre daha normal bulunmuştur (p

Background/Aim: Antenatal magnesium sulfate (MgSO4) treatment is widely used for fetal neuroprotection in women at risk of preterm delivery. Possible adverse effects of MgSO4 include respiratory depression and delay in closure of ductus arteriosus by antagonism of calcium channels. The aim of this study was to investigate the effects of antenatal MgSO4 exposure on cardiorespiratory complications during the early neonatal period in premature infants.Methods: A retrospective cohort study was performed on 340 preterm infants born between 23 and 32 weeks of gestational age. Patients were divided into two groups according to antenatal MgSO4 exposure: The MgSO4 group (n=186) and the no-MgSO4 group (n=154). Outcomes were acute cardiorespiratory events (intubation at birth, respiratory support, and hypotension in first day of life), and hemodynamically significant patent ductus arteriosus (HsPDA).Results: Mothers in the MgSO4 group were more likely to have preeclampsia and antenatal steroid treatment, while their infants were younger in gestation and weighed less (P

A case representing neonatal jaundice that includes direct and indirect hyperbilirubinemia was diagnosed with classical galactosemia. Even though she was initially approached as a neonatal sepsis case, after the cessation of her milk consumption, jaundice resolved, and the diagnosis was made and supported by additional diagnostic tools. It has been shared to emphasize the importance of assessment and urgent management of the disease during the neonatal period., Sarılık nedeniyle başvuran direk ve indirek hiperbilirubinemi saptanan yenidoğan olgusunda klasik galaktozemi tanısı konulmuş ve genetik mutasyon sonucuyla tanı doğrulanmıştır. Bu olgu, yenidoğan döneminde saptanan sarılığın galaktozemi açısından acil değerlendirilmesinin ve tedavisinin önemini vurgulamak için paylaşılmıştır.

© 2022 Wiley Periodicals LLC.Objectives: Postoperative ventilatory strategies in patients with esophageal atresia (EA) and tracheoesophageal fistula (TEF) may have an impact on early postoperative complications. Our national Esophageal Atresia Registry was evaluated to define a possible relationship between the type and duration of respiratory support on postoperative complications and outcome. Study Design: Among the data registered by 31 centers between 2015 and 2021, patients with esophago-esophageal anastomosis (EEA)/tracheoesophageal fistula (TEF) were divided into two groups; invasive ventilatory support (IV) and noninvasive ventilatory support and/or oxygen support (NIV-OS). The demographic findings, gestational age, type of atresia, associated anomalies, and genetic malformations were evaluated. We compared the type of repair, gap length, chest tube insertion, follow-up times, tensioned anastomosis, postoperative complications, esophageal dilatations, respiratory problems requiring treatment after the operation, and mortality rates. Results: Among 650 registered patients, 502 patients with EEA/TEF repair included the study. Four hundred and seventy of patients require IV and 32 of them had NIV-OS treatment. The IV group had lower mean birth weights and higher incidence of respiratory problems when compared to NIV-OS group. Also, NIV-OS group had significantly higher incidence of associated anomalies than IV groups. The rates of postoperative complications and mortality were not different between the IV and NIV-OS groups. Conclusion: We demonstrated that patients who required invasive ventilation had a higher incidence of low birth weight and respiratory morbidity. We found no relation between mode of postoperative ventilation and surgical complications. Randomized controlled trials and clinical guidelines are needed to define the best type of ventilation strategy in children with EA/TEF.

Purpose: The aim of this study is to determine clinical comfort, worry and status of liking children among pediatric nursing students studying in universities located in east and west of Turkey. Methods: The data of this descriptive and correlational study were collected in nursing faculties located in east (A University) and west (B University) provinces between April-May 2020. The sample of the study consisted of 211 students who participated in the online survey voluntarily between the specified dates. The data of the study were collected using “Sociodemographic Characteristics Form”, “Clinical Comfort and Worry Assessment Tool of Pediatric Nursing Students” and “Barnett Liking of Children Scale (BLCS)”. Results: In the study, the comfort subscale mean score was higher in the nursing students studying in the University B and the difference was found to be statistically significant (p0.05). It was determined that there was a statistically positive moderate significant correlation between levels of liking children and the comfort subscale and a statistically negative moderate significant correlation between levels of liking children and the worry subscale in nursing students studying in the Universities A and B. Conclusions: It was found that the liking of children status of the students studying in the Universities A and B was high. Students' levels of stress, anxiety and liking children in the pediatric clinic rotation should be determined.

Amaç: Scimitar sendromu, pulmoner venlerin sol atriyum yerine inferior vena kavaya (IVC) açıldığı ve sıklıkla ek kardiyak ve pulmoner anomalilerle ilişkili olduğu nadir görülen bir doğuştan kalp anomalisidir. Bu yazıda farklı klinik özellikleri olan Scimitar sendromlu pediyatrik hastalar tartışılmıştır.Gereç ve yöntem: Hastanemizde 2000-2020 yılları arasında Scimitar sendromlu tanısı alan olgular çalışmaya alındı. Hastaların klinik bulguları, anjiyografik ve cerrahi işlemler ve takipleri değerlendirildi.Bulgular: Çalışma süresi içinde yaşları 1,5 ay ile 10 yaş arasında Scimitar sendromu tanısıolan beş hasta değerlendirildi. Tüm hastalar semptomatikti. Bir hastada kor triatriatum ve pulmoner venöz stenoz, bir hastada sol atriyal izomerizm ve IVC yokluğu (azigos ven devamlılığı) ve diğer hastada aort koarktasyonu vardı. Diğer bir hastada ise çift drenaj saptandı. Bu hastada İVC’nin meandering pulmoner venler aracılığıyla sol atriyum ile olan bağlantısı Scimitar varyantı olarak değerlendirildi. Pulmoner hipertansiyonlu infantil bir hasta ve pulmoner / sistemik akım oranı (Qp/Qs)>1,5 olan iki hasta reanastomoz tekniği ile cerrahi olarak tedavi edildi. İki hastada ise aortopulmoner kollateraller saptanarak bu olgulara vasküler embolizasyon (vasküler plug, koil ve onyx kullanılarak) yapıldı.Sonuç: Scimitar sendromunun çok çeşitli anatomik ve klinik varyasyonları olması nedeniyle tedavi ve takip kişiye özel olarak planlanmalıdır., Purpose: Scimitar syndrome is a rare congenital cardiac anomaly in which pulmonary veins are drained to the inferior vena cava (IVC) instead of the left atrium and it is often associated with additional cardiac and pulmonary anomalies. In this article, the different clinical features of pediatric patients with Scimitar syndrome are reported.Material and methods: All patients with scimitar syndrome were diagnosed in our hospital between 2000 and 2020. The clinical findings, angiographic and surgical procedures, and follow-up of the patients are evaluated.Results: Five pediatric patients aged between 1.5 months and 10 years were diagnosed as Scimitar syndrome. All patients were symptomatic. One patient had cor triatriatum and pulmonary venous stenosis, one patient had left atrial isomerism and absence of the IVC (azygous continuity), and another patient had coarctation of the aorta. One patient had dual drainage: the IVC and left atrium with meandering pulmonary veins, which we determined as a Scimitar variant. One infant patient with pulmonary hypertension and two patients with pulmonary to systemic flow ratio (Qp/Qs)>1.5 were treated surgically with the reanastomosis technique. Vascular embolization of the aortopulmonary collaterals was performed in two patients using vascular plugs, coils, and onyx.Conclusion: Treatment should be planned individually in this syndrome due to Scimitar syndrome has a wide range of anatomic and clinical variations.

BackgroundThe aim of this study was to evaluate the prevalence of anxiety, depression, sleep, and associated factors in caregivers of children with spinal muscular atrophy (SMA). Materials and MethodsBeck Depression Inventory (BDI), the State-Trait Anxiety Inventory-State (STAI-S), the State-Trait Anxiety Inventory-Trait (STAI-T), and Pittsburgh Sleep Quality Index (PSQI) were used to assess the anxiety, depression, and sleep quality of the caregivers of children with SMA. Higher scores indicated worse outcome for all three questionnaires. ResultsFifty-six caregivers of children with SMA were included in the study. Median age of children was 6 (3.2-10) years and mean age of the caregivers was 37.0 +/- 6.5 years. Median scores of the BDI, STAI-S, STAI-T, and PSQI were 12 (7.2-17), 35.5 (31-44), 40.5 (35-48), and 7.0 (5.0-10.0), respectively. There was a positive correlation between BDI and PSQI scores (p < 0.05). There was a negative correlation between the age of the caregivers and PSQI, BDI, STAI-T scores (p = 0.01, r = -0.341; p = 0.006, r = -0.364; p = 0.003, r = -0.395, respectively). There was a negative correlation between the age of the patients and the PSQI scores of the caregivers (p = 0.01, r = -0.33). There was a negative correlation between BDI scores and household income (p = 0.01, r = -0.34). ConclusionCaregivers of children with SMA had elevated depression and anxiety levels and they also had decreased sleep quality. Economic and social support resources are needed to help caregivers of those children.

12 day male patient followed with supracardiac total anomalous pulmonary venous connection (TAPVC) was admitted to our service after one day of surgical repair .The patient extubation attempts failed three times because of the atelectasis occurred in the lungs. As conventional therapy failed to improve Atelectasis, dornase alpha was tested via intubation cannula . It avoided the recurrence of atelectasis and the patient was discharged with no oxygen ., 12 day male patient followed with supracardiac total anomalous pulmonary venous connection (TAPVC) was admitted to our service after one day of surgical repair .The patient extubation attempts failed three times because of the atelectasis occurred in the lungs after the surgery. Atelectasis was treated with installed dornase alpha. It avoided the recurrence of atelectasis and the patient was discharged with no oxygen .

Objective Headache is a complaint with an increasing rate in pediatric outpatient clinics, and it is more common in adolescence when children can express themselves more easily. In this study, we aimed to examine the incidence of migraine in patients admitted to our outpatient clinic with headache, and the sociodemographic factors and social effects affecting migraine attacks in patients diagnosed with migraine.Material and Methods: 308 children between the ages of 11-17 who presented to Aksaray Education and Research Hospital Pediatri Outpatient Clinic between October 2018 and December 2019 with headache were included. A mini questionnaire consisting of 15 questions was given to the patients with migraine symptoms to define their headache more easily. The second questionnaire was applied to the patients who were evaluated in the outpatient clinic for the second time and diagnosed with migraine, to define social environmental factors and migraine attacks.Results: The median age of the patients was 13.7 ± 1.1 years. 127 of these patients (41.2%) were male and 181 (58.8%) were female. Migraine was diagnosed in 26 patients (8.4%) out of 308 patients. When comparing the gender factor and computer use, it was found that there were 4 boys (44.4%) and 1 girl (17.7%) who had long-term computer use before migraine attack (p = 0.043). It was found that there were 6 girls (46.2%) and 1 boy (11.1%) who stated that they had problems with their friends during the day before the attack (p = 0.017).Conclusion: As a result, it was seen in our study that the more frequent use of technological devices such as mobile phones and long-term computer use in the daily lives of adolescents and children affected migraine attacks., Giriş ve Amaç: Baş ağrısı çocuk polikliniklerinde giderek artan bir şikayettir ve ergenlik döneminde çocukların kendilerini daha kolay ifade edebildikleri dönemlerde daha sık görülür. Bu çalışmada, polikliniğimize baş ağrısı ile başvuran hastalarda migren sıklığını, migren tanısı almış hastalarda migren ataklarını etkileyen sosyodemografik faktörleri ve sosyal etkileri incelemeyi amaçladık.Gereç ve Yöntemler: Aksaray Eğitim ve Araştırma Hastanesi Çocuk Sağlığı ve Hastalıkları Polikliniği'ne Ekim 2018 - Aralık 2019 tarihleri arasında baş ağrısı şikayeti ile başvuran 11-17 yaş arası 308 çocuk dahil edildi. Migren semptomları olan hastalara ağrılarını daha kolay tanımlayabilmek için 15 sorudan oluşan mini anket verildi. İkinci anket polikliniğinde ikinci kez değerlendirilen ve migren tanısı alan hastalara sosyal çevresel faktörleri ve migren ataklarını tanımlamak için uygulandı.Bulgular: Hastaların ortanca yaşı 13.7 ± 1.1 yıldı. Bu hastaların 127'si (% 41,2) erkek, 181'i (% 58,8) kadındı. 308 hastanın 26'sında (% 8.4) migren tanısı kondu. Cinsiyet faktörü ve bilgisayar kullanımı karşılaştırıldığında, migren atağı öncesinde uzun süreli bilgisayar kullanan 4 erkek (% 44,4) ve 1 kız (% 17,7) olduğu saptandı (p = 0,043). Atak öncesinde gün içerisinde arkadaşlarıyla problem yaşadığını belirten 6 kız (%46,2) ve 1 erkek (%11,1) olduğu saptandı (p=0,017).Sonuç: Çalışmamızda ergen ve çocukların günlük yaşamlarında cep telefonu ve uzun süreli bilgisayar gibi teknolojik cihazların daha sık kullanımının migren ataklarını etkilediği görüldü. Ayrıca stresli ilişki durumlarının genç migren hastalarında özellikle kızlarda atakları şiddetlendirebileceği tespit edilmiştir. Daha geniş hasta popülasyonu ile randomize kontrollü prospektif çalışmaların çocuk ve ergenlerde migren ataklarını etkileyen faktörler ve sosyodemografik veriler için literatüre katkı sağlayacağını düşünüyoruz.

Purpose: The aim of this study was to evaluate the lung-protective mechanical ventilation strategy, early enteral nutrition, negative fluid balance, and adequacy of hospital resources in our pediatric intensive care unit.Materials and Methods: This study included 32 patients who developed acute respiratory distress syndrome (ARDS) during their monitoring in the pediatric intensive care unit.Results: According to their oxygenation status, 14 patients (43.8%) had mild ARDS, nine patients (28.1%) had moderate ARDS, and nine patients (28.1%) had severe ARDS. High-frequency oscillatory ventilation was applied to three patients (9.3%), and four patients (12.5%) received extracorporeal membrane oxygenation (ECMO) support. The most common complications were nosocomial infection (31.3%) and pneumothorax (12.5%). The mortality rate was 6.3%. The survival rate was 75.0% in patients with ECMO support. The patients with a higher Pediatric Index of Mortality (PIM-2) score confronted more severe ARDS, and non-pulmonary ARDS also progressed in advanced stages.Conclusion: In patients with high PIM-2 and PELOD scores, attention must be given to the development of severe ARDS. The lung-protective mechanical ventilation support, early enteral nutrition, negative fluid balance practices, and the adequacy of hospital resources led to a successful survival rate in our study. However, multicenter randomized controlled trials are needed on this subject., Amaç: Bu çalışmanın amacı akciğer koruyucu mekanik ventilasyon stratejisi, erken enteral beslenme, negatif sıvı dengesi ve hasta kaynaklarının yeterliliğinin akut solunum sıkıntısı sendromu olan çocuklarda sağ kalım üzerine etkisini değerlendirmektir. Gereç ve Yöntem: Çalışmaya çocuk yoğun bakım ünitemizde akut solunum sıkıntısı sendromu gelişen 32 hasta dahil edildi. Bulgular: Oksijenizasyon durumlarına göre 14’ü hafif (% 43.8), 9’u orta (% 28.1) ve 9’u ağır (% 28.1) evre akut solunum sıkıntısı sendromu gelişmiş idi. Üç hastaya (% 9,4) yüksek frekanslı osilasyon ventilasyon, dört (% 12,5) hastaya ekstrakorporeal membran oksjenizasyon desteği sağlandı. En sık görülen komplikasyonlar ventilatör ilişkili pnömoni (% 21.9) ve pnömotoraks (% 12.5) idi. Mortalite oranı % 6.3 idi. Ekstrakorporeal membran oksjenizasyon uygulanan hastalarda sağ kalım oranı %75 idi. Pediatric Index of Mortality-2 skoru yüksek olan ve non-pulmoner kaynaklı akut solunum sıkıntısı sendromu hastaların takibi sırasında gelişebilecek akut solunum sıkıntısı sendromunun şiddetinin daha ağır olduğu görüldü. Sonuç: Akciğer koruyucu mekanik ventilasyon desteği, erken enteral beslenme, negatif sıvı dengesi ve yeterli hastane kaynakları sağkalımı arttırabilir. Ancak, çok merkezli randomize kontrollü çalışmalara ihtiyaç vardır.